Key result
Minimally invasive mitral surgery yields 0% operative mortality and speeds recovery versus conventional sternotomy.
Why the study?
Minimally-invasive mitral valve surgery is increasingly used for isolated valve disease without concomitant coronary bypass, but detailed outcomes and techniques require description.
Does minimally-invasive mitral valve surgery improve recovery and reduce resource utilization compared to conventional sternotomy in patients with isolated valve disease?
Observational (n=273)
No
Does minimally-invasive mitral valve surgery improve recovery and reduce resource utilization compared to conventional sternotomy in patients with isolated valve disease?
Minimally-invasive mitral valve surgery is safe, with zero operative mortality in this series, and offers faster recovery than conventional sternotomy.
Supports technical feasibility at experienced centers; leaves open randomized comparisons for safety and durability.
Minimally-invasive surgery is increasingly being utilised in patients with isolated valve disease who do not require concomitant coronary bypass. Minimally-invasive valve surgery has been performed at the Brigham and Women's Hospital, Harvard Medical School since July 1996 and has now been used in over 273 mitral valve operations, primarily valve repairs. The incisions used have evolved; we used a right para-sternal approach at first and have now changed to a lower mini-sternotomy. The operative techniques employed through this incision are identical to those used in a complete sternotomy. Operative mortality in our mitral valve series is zero. There have been five re-operations. The length of hospital stay and amount of blood utilised are both less than with a complete sternotomy. Most importantly, the patients' return to normality after complete recovery was quicker by approximately 2 weeks versus the conventional sternotomy. Minimally-invasive mitral valve surgery is a technique that can be utilised reproducibly for all techniques of repair or replacement.
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Lawrence H. Cohn (2000) conducted an observational in Isolated valve disease (n=273). Minimally-invasive mitral valve surgery vs. Conventional sternotomy was evaluated on Operative mortality. Minimally-invasive mitral valve surgery resulted in 0% operative mortality across 273 operations and accelerated return to normality by approximately 2 weeks versus conventional sternotomy.
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